Journal of Pediatric Psychology最新文献

Objective: Insufficient sleep duration and poor sleep quality are common in adolescence. Poor sleep health can negatively impact cardiometabolic outcomes (e.g., obesity, insulin resistance), but specific psychosocial factors shaping sleep in adolescents with or at risk for type 2 diabetes (T2D) are unknown.

Methods: Twenty-one adolescents with T2D and/or obesity were recruited from a weight management clinic and completed 1 week of at-home actigraph sleep monitoring. Semi-structured qualitative interviews were conducted with adolescents and their parents separately to generate information about adolescents' sleep characteristics, perceived barriers and facilitators of sleep, and parents' roles in sleep health. The data were coded by two coders and analyzed thematically.

Results: Actigraphy results revealed an average low sleep duration (6.6 hr/night). Nearly all participants endorsed a preference for late bed and wake times, yet actigraphy showed low social jetlag (average 0.6 hr). Participants acknowledged the connection between sleep and mental health but rarely discussed the relationship between sleep and cardiometabolic health. Technology use and anxiety were commonly reported barriers to sleep health, whereas facilitators included calming behaviors and an established sleep/wake schedule. Parents expressed ambivalence about their involvement in teens' sleep health. They shared desire to instill healthy sleep habits without creating household conflict.

Conclusions: Findings revealed barriers and facilitators to healthy sleep that represent opportunities for intervention, such as educating adolescents on the connection between sleep and cardiometabolic health and supporting parents to establish and enforce sleep rules. Future research should develop and test adolescent-informed interventions for healthy sleep and evaluate related cardiometabolic health outcomes.

Objectives: Spirituality is a recognized element of palliative care, with documented benefits for adult patients. However, limited research exists on how religion and spirituality affect children at end-of-life (EOL) and their parents. This review aimed to evaluate the quality of existing studies, describe the spiritual and religious beliefs and practices of pediatric patients and their parents, examine how these factors influence care, coping, and decision-making, and assess the importance of spiritual support during EOL.

Methods: A systematic review was conducted according to PRISMA guidelines. This review included 21 reports with 18 from database searches (MEDLINE, CINAHL, PsycINFO) and 3 from hand-searched references published between 2013 and 2024. The date last searched was December 31, 2024. Study quality was assessed using the Standard Quality Assessment Criteria (QualSyst).

Results: Findings revealed diverse religious and spiritual practices among families, including faith stability, spiritual care use, and prayer. Key outcomes associated with spirituality included enhanced coping, acceptance, meaning-making, hope, caregiver spiritual well-being, decision-making, and improved parent-child communication. Across studies, spiritual support emerged as a vital component of the pediatric EOL experience.

Conclusions: The review highlights the significant role of religion and spirituality for parents navigating their child's EOL, with implications for emotional and psychological support. These findings underscore the importance for healthcare providers to recognize and integrate spiritual care into pediatric palliative settings. However, the lack of direct pediatric patient input indicates a need for further research to understand how children experience and are influenced by their own religious and spiritual beliefs at EOL.

Objective: Chronic headaches are one of the most prevalent health complaints in children and are associated with substantial impairments in daily life. Given the scarcity of specialized pediatric chronic pain treatment, educational websites delivering evidence-based information in a comprehensible, child-friendly way offer a promising alternative. In this pilot study, a single-arm intervention was conducted to investigate changes in headache outcomes following a guided, website-based pain education (Los Cabezudos) for Spanish schoolchildren and to explore associations with age.

Methods: From eight school classes, all children who consented were eligible to participate. N = 210 schoolchildren (10-14 years; M = 11.8, SD = 1.2) participated in two guided website-based headache education sessions at school. Headache knowledge, pain self-efficacy, pain intensity, and pain interference were measured before the intervention and at 1- and 2-month follow-up. Linear mixed multilevel models were used to detect the effects of time.

Results: Significant improvements were observed across all outcomes. Headache knowledge (b = 0.20, p < .001), pain self-efficacy (b = 0.22, p < .001), pain intensity (maximum: b = -0.27, p = .002; average: b = -0.27, p = .001), and pain interference (b = -0.30, p = .002) all improved significantly over time in children with recurrent headaches (n = 26). No significant interactions with age were found.

Conclusions: The results support the potential of a website-based educational intervention to improve key headache-related outcomes: knowledge, self-efficacy, intensity, and interference. Future randomized controlled trials are warranted to investigate the long-term effectiveness of pediatric website-based pain education.

Objective: Sibling relationships have important implications for individual development and functioning. Evaluating this relationship within the family context is important as it both operates within and is influenced by the family. Research on sibling relationship quality among survivors of pediatric cancer is limited. This study assessed survivor-reported sibling closeness, and the individual- and family-level factors associated with closeness within six months after completing cancer treatment.

Methods: This study is a secondary analysis of a larger study including survivors of pediatric brain tumors and solid tumors. Participants included survivors (n = 73; ages 7-14; Mage = 10.87; Female = 39.7%) that reported having a sibling (Mage = 11.66; Female = 53.4%) and their caregiver (Mage = 43.22; Female = 80.8%). Caregivers completed measures of survivor and family functioning, and a demographic survey. Survivors reported on sibling relationship quality. T-tests, correlations, and a linear regression evaluated hypothesized associations.

Results: In univariate analyses, sibling order was significantly related to closeness such that survivors with an older sibling reported higher levels of closeness compared to those with a younger sibling. Correlations revealed that older sibling age, better family functioning, and fewer survivor externalizing symptoms were significantly related to higher levels of closeness. Linear regression analysis indicated that family functioning was significantly associated with sibling closeness.

Conclusions: Family functioning is uniquely related to sibling relationship quality in survivors of pediatric cancer, beyond individual survivor- and sibling-related factors. Longitudinal research should examine how sibling relationships vary over time, from diagnosis, through treatment, and into remission.

Objectives: Congenital cytomegalovirus (cCMV) is the leading infectious cause of hearing loss and neurodevelopmental impairment in children, yet the psychosocial impact has only recently begun to be explored. The objectives of this study were to describe the experiences of children and families affected by cCMV, and examine the use of clinical psychology as a model of care.

Methods: Thirty-four families were recruited from a specialist cCMV clinic and invited to access developmental assessment and individual formulation-based clinical psychology intervention, including facilitated parent peer support.

Results: Birth mothers were significantly more stressed than fathers, and poorer parental well-being was associated with negative perception of life changes following cCMV diagnosis, but not related to disease severity. Following clinical psychology intervention, parents reported significant improvements in understanding and confidence in managing their child's needs. However, well-being remained varied, which may reflect the ongoing prognostic uncertainty of having a child with cCMV. Thematic analysis of parental experiences identified five themes: (1) processing the experience of cCMV, (2) disrupted newborn phase, (3) relationship to healthcare, (4) lack of shared experiences, and (5) raising awareness.

Conclusion: Clinical psychology was positively received as a protected space to explore and validate the emotional impact of cCMV, and facilitate connection with others who share personal experience of cCMV. The findings support the use of embedded clinical psychology provision for families affected by cCMV, and the importance of increasing cCMV awareness to improve pathways of care and reduce psychological distress.

Objective: In middle childhood and into adolescence, children increasingly engage in cooking activities using devices that can elevate their risk of experiencing burn and cut injuries. There is limited research, however, on what kitchen devices they use at different ages and their knowledge of unsafe cooking activities.

Method: Focusing on burn and cut risks, this study considered younger (10-11 years old) and older children (13-14 years old) and used parent reports to determine the kitchen devices children use, under what supervision conditions, and the factors parents considered in deciding on their child's readiness to do so. Additionally, children viewed a videotape of a similarly aged child engaging in various kitchen activities while cooking and identified actions they considered unsafe. Their parent did similarly to identify the risky activities they expected their child to recognize.

Results: Older age children used more kitchen devices without parent supervision than younger-aged children. In making decisions about burn-risk devices, parents considered dangerousness as well as the benefits to them of their child doing so, though injury severity risk did not contribute, and none of these factors predicted decisions about the usage of cut-risk devices. Regardless of age, children identified fewer than half of the injury-risk behaviors shown, and parents believed that children would identify a significantly greater proportion of risks than children actually did.

Conclusions: Children are not aware of many risk behaviors in the kitchen, and parents significantly overestimate their child's knowledge of such behaviors. Implications for injury prevention and directions for future research are discussed.

Objective: A Type 1 diabetes (T1D) diagnosis can be overwhelming for families. Family support during the first year may improve psychosocial outcomes. Grounded in theory and based upon the lived experiences of youth with T1D and their caregivers, the Teaming up for T1D through Telehealth (Triple T) intervention was developed to promote psychosocial adjustment during the first year post-diagnosis. We describe the development of a personalized telehealth intervention supported by a video library depicting common T1D experiences.

Methods: Age-specific focus groups and subsequent individual interviews explored the successes, challenges, fears, and advice of youth and their families within 2 years of diagnosis. Children (8-12 years; n = 10), teens (13-17 years; n = 11), their caregivers (n = 27), and caregivers of children diagnosed younger than 8 years (n = 12) participated.

Results: Focus groups informed the development of a video library and 6 personalized telehealth sessions throughout the first year post-T1D diagnosis. Five main themes emerged and informed video development: Reassurance that families will be "Okay," strategies for getting to "Okay," managing activities, handling diagnosis disclosure, and family teamwork. Test videos were reviewed by focus groups and revised based on feedback. The video library remained accessible throughout the intervention. The telehealth sessions reviewed families' successes and challenges, provided behavioral health strategies to promote coping and adherence, and recommended specific videos based on each discussion.

Conclusions: This approach to telehealth was informed by youth and caregiver experiences and recommendations. This approach may directly address the needs of families and inform future interventions and education following a T1D diagnosis.

Objective: This study presents a novel interview and coding system to assess the transition from pediatric to adult healthcare in individuals with spina bifida (SB). Inter-rater reliability, descriptive data, and demographic and condition severity correlates are reported.

Methods: Young adults with SB, aged 19-26 at Time 6 (n = 86) of a longitudinal study, completed the Transition to Adult Healthcare in Young Adults with Spina Bifida Interview which assessed: (1) the transition status (pediatric vs. adult) of primary care providers, (2) the transition status of specialist providers, (3) transition-related discussions and meetings with health professionals, (4) subjective reports of transition status, and (5) self-reports of how medical complications/emotional problems are managed during the transition.

Results: Findings revealed high levels of inter-rater reliability. A large percentage (30%-48%) reported having specialty providers who were pediatric-oriented. Half reported that they had not had a transition-related discussion or were advised not to begin the transition process. Roughly half reported that they had not transitioned or were still in the planning phase. Most reported that they could make their own decisions regarding medical complications, but felt less able to assess the urgency of a complication, the need for action, or how to prevent a complication. Shunt status was associated with several transition status indicators.

Conclusions: This study supports the use of an interview-based measure in young adults with SB. Findings revealed that a large percentage of young adults aged 19-26 had not transitioned to adult healthcare and felt ill-equipped to manage health complications.